Asperger's Syndrome Characteristics

Asperger’s Syndrome: A Brief Summary

Asperger’s Syndrome is a condition that was initially described by Dr. Hans Asperger’s 1944 doctoral thesis. It was not until 37 years later, in 1981, however, that Dr. Lorna Wing used the term "Asperger’s Syndrome" in a paper that helped to introduce this condition to the English-speaking world.

As described by Dr. Wing, the primary clinical features of Asperger’s Syndrome include:

naïve, inappropriate, one-sided social interactions
limited ability to establish relationships
poor non-verbal communication
a lack of emotional empathy
pedantic, repetitive speech
intense absorption in certain subjects
clumsy, un-coordinated movements
odd postures

Currently, the prevailing view is that Asperger’s Syndrome is a Pervasive Developmental Disorder which falls at the high end of the Autism Spectrum continuum.

Definition | Diagnostic Criteria | Clinical Features
Socialization | Language | Social | Communication

BEHAVIORAL DEFINITION

The autism spectrum extends from "classic autism" -- which lies at the lower end of the spectrum-- through ASPERGER’S SYNDROME, which is characterized as being at the mildest and highest functioning end of the spectrum --or Pervasive Developmental Disorder--Continuum

The major source of stress in life for the person with Asperger’s Syndrome is social contact, and increased stress generally leads to anxiety disorders and depression Attwood, T. Asperger’s Syndrome: A Guide for Parents and Professionals, 1998, p. 148.

AS represents a neurologically-based disorder of development

AS reflects deviations or abnormalities in four aspects of development:

(1) Social relatedness and social skills

(2) The use of language for purposes of communication

(3) Certain behavioral and stylistic characteristics such as repetitive or persevering features

(4) Limited, but intense, range of interests

These dysfunctional features can range from mild to severe

"The Epidemiology of Asperger Syndrome: A Total Population Study" by Ehlers and Gillberg (retrieve citation) 2001), it is estimated that the prevalence of Asperger is 2.6 per 1,000 individuals. With the population of the U.S. currently estimated at 275 million (July 2000), this would mean an estimated 715,000 people are affected by Asperger’s syndrome in the U.S. alone"
Stewart, K. (2002). Helping a Child with Nonverbal Learning Disorder or Asperger’s Syndrome, p. 148

AS is characterized by:

high cognitive abilities -- or, at least, "normal" IQ level

extending into the very superior range of cognitive ability

normal language function when compared to other autistic disorders

difficulties with pragmatic, or social language

a better prognosis than other Autism spectrum disorders

Individuals with autism also have gifts. The gifts of autism occur as a result of the strong visual abilities, attention to minute details, unusual interests, and amazing memory. Other common traits, such as honesty, naivetè, gentleness, compliance, and perfectionism, are exceedingly refreshing and unexpected in this increasingly cynical world. Janzen, J. E. (1999). Autism: Facts and strategies for Parents, p. 151.

Nurses are in a position to identify children with Asperger’s early. After identification, the necessary referrals, treatment options, support, and follow-up are essential for these children. Nurses need more knowledge about this disorder and need to be proactive in defining their role to help children with the disorder in the schools and the community. Marshall, M.C. Asperger’s syndrome: Implications for nursing practice. Issues in Mental Health Nursing, 2002; 23(6), p. 605.

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Diagnostic Criteria from DSM-IV-TR (2000)

American Psychiatric Association, Washington, D.C.
http://www.psych.org (Diagnostic and Statistical Manual of Mental Disorders)

Asperger’s Disorder

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

(2) failure to develop peer relationships appropriate to developmental level

(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)

(4) Lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

(1) encompassing preoccupation with one or more stereo-typed and restricted patterns of interest that is abnormal either in intensity or focus

(2) apparently inflexible adherence to specific, nonfunctional routines or rituals

(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

(4) persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrase used by age 3 years)

E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

While there is no cure for Asperger’s, experts agree that the earlier a child is properly diagnosed and receives individualized assistance, the better the chance that he can lead a quality life Parade Magazine, February 2, 2003; pp. 4-5

People with Asperger’s Syndrome may have unusual qualities to their language skills that superficially resemble the speech and thought disorder associated with schizophrenia...this can be confusing to the clinician who is not aware of this aspect of Asperger’s Syndrome Attwood, T. (1998). Asperger’s Syndrome: A Guide for Parents and Professionals, p. 149.

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AS: Clinical Features

One of the primary features of Asperger’s syndrome is their passion for favorite topics or special interests

Some of these areas include:

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AS: Socialization Deficits

Different from "typical" Autism
Described as being "in OUR world, but, ON THEIR OWN terms"
Preoccupied with own agenda
Seldom interested in other’s interests/concerns
By school age express desire to fit in socially
Highly frustrated by their social awkwardness/alienation
Lack effective interaction skills -- not desire
Difficulties making social connections
Unable to "read" others’ needs and perspectives
Unable to appropriately respond to social cues
Frequently described as "odd" or selfish
Naïve and lack common sense
Lack understanding of human relations and rules of social convention
Are inflexible and incapable of coping with change
Easily stressed and emotionally vulnerable

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AS: Use of Language

Rote skills are strong
Prosody -- speech volume, intonation, inflection, rate -- is frequently deficient or unusual
Excessively formal or pedantic language
Misused or not used cultural slang or social idioms
Concrete language rather than abstract
Weak pragmatic -- conversational -- skills
Problems with taking turns in conversations
Typically revert to favorite topic area
Difficulty understanding humor
Laugh at "wrong time" with jokes or interactions
Many have good sense of humor
Usually like word games and puns
Hyper-verbal (highly developed vocabularies)
Early years: repetitive phrases or language or stock phrases from memorized material
Some have normal or early language development others have speech delays, then rapidly catch up, making diagnosis between AS, autism, and speech disorders difficult

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AS: Social Issues

AS children typically display impaired Social Interaction

Practical Suggestions:

Shield them from bullying and teasing
Educate peers
Praise classmates when supportive
Promote empathy and tolerance
Create cooperative learning situations

Examples: Use AS child’s strengths in exchange for liabilities to foster acceptance

Teach and support proper reaction to social cues
Rehearse proper response repertoires
Teach WHAT to say, WHEN, and HOW to say it
Model two-way interactions
Teach/model correct emotional responding
Insensitive or inappropriate comments from AS are usually innocent
Teaching WHY & WHAT response is appropriate is necessary
Encourage participation in conversations

Adapted from: Williams, K. (1995). Understanding the student with Asperger’s Syndrome: Guidelines for Teachers. Focus on Autistic Behavior, Vol. 10, #2.

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AS: Communication & Gestures

Six steps for understanding challenging communications:

(1) Try to figure out what your child is communicating with the challenging behavior.

- "This is too difficult for me"

- "I can’t remember what I’m supposed to do"

- "I’m mad...scared...confused"

(2) Consider how you can adapt the situation

Child expressing confusion -- Consider how to make the situation easier to understand. Make it more concrete, routine, or predictable

Child overwhelmed or overstimulated -- Try reducing amount of time in situation, or avoiding it in future.

(3) If the message must be communicated, come up with alternate way in which your child can communicate his or her needs or wishes more appropriately

Help your child develop appropriate ways of conveying requests/needs. If screaming when confused by a task, teach child to raise hand, ring a bell, or say: "I need help with this...this is too hard"

(4) Practice the "new way" of communicating

model more appropriate phrase or nonverbal signals
have child practice the "new phrase" or behavior
during the situation, remind (prompt) child to use new phrase or behavior

(5) Reward your child for using the strategy by showing that it gets his or her needs met

if your child requests help assist her immediately
if asks to leave situation, provide her with immediate break
if needs attention, stop what you’re doing and provide some time/interest

(6) Be sure that the challenging behavior is no longer effective in getting your child’s needs met.

ignore problem behaviors
provide prompt for the "new", appropriate one
if child screams to avoid situation, prompt her to use an appropriate phrase. Do NOT allow her to leave the situation while she is screaming.

Ozonoff, S., Dawson, G., & McPartland, J. (2002). A parent’s guide to asperger syndrome and high-functioning autism: How to meet the challenges and help your child thrive. New York, NY: The Gilford Press.pp. 132-140.

U.S. Annual Growth in Number of Persons (ages 3 - 22) with Autism from December 2000 to December 2003

Visit FightingAutism.org to graph data for your state.